My GP has told me that 80% of their appointments don't need a GP appointment.

It's about 25 years since such a "perfect world" system existed in the UK GP system.

I haven’t been to a GP in 12 years. I’ve needed the pharmacy a few times, but never bothered the GP with anything.

I don’t actually understand what everyone is always needing to see a doctor for. Of course people will have actual illnesses or suspected illnesses, but it can’t possible be hundreds of people in every town every day. So I believe most of those people queuing up for an appointment really do not need to be there.

I agree, several times when I've used the online system and it's deleted all of the info I painstakingly type in because I answered incorrectly "pain has lasted 1 month" on the last question I think fuck this and don't bother going through it all over again. It just makes it more frustrating because it feels like that's exactly what they want with those systems.

@C8H10N4O2

The whole point of the family doctor system is to have patient histories, ideally some background on the patient and to be able to assess what is minor and treatable at GP level what needs taking further. That is what the years of training and experience attracting the bigger salaries are for. If GPs are unable to provide that service but minimum wage reception staff can fill at check box and that is good enough then what is the point of the system?

I think that idea has long since gone. You never see the same GP twice anymore, let alone a long term relationship. And the ones you do see often havn't bothered reading your notes/medical history, so you have to remind them of your conditions, diagnoses, past consultations, etc.

Triage is one of the hardest things to do in medicine. It's really hard to believe that any grown adult thinks a receptionist can do it reliably. How would anyone think that? Do they just not understand what medical training is for??

Research has shown over and over and over that the most effective primary care model is one in which every patient gets a face to face appointment that is as long as they need, be that 3 minutes or two hours. It saves millions and millions throughout the system by making sure a person with a relatively minor illness gets all the help they need before it becomes a major illness. Primary care also needs to include support around loneliness and isolation, helping people to resolve housing issues and all the various social problems that contribute to poor health.

I'd love to see that statistic broken down into demographics, such as age groups, health conditions, employment status etc. Barely anyone I know goes to the GP even when they need to. My OH has incurable cancer but seldom goes to the GP and will "wait and see" for whatever condition/side effect he is suffering from to see if it clears up on it's own. I suspect most of the statistic is made up of a relatively small number of "serial" appointment seekers. The old 80-20 rule probably in play whereby 20% of the patient base makes up 80% of the unnecessary appointments.

But they are and that’s really dangerous.

There's not much a GP can ask you that isn't a routine list of questions that a Receptionist can ask. They can have a feel around and see where you have pain or if anything feels different than a healthy human body, but they don't have X-Ray vision. Some cancers have very vague symptoms and they have to make a judgement call about if there's enough there for a very expensive and stressful referral or if it's likely to just be an over-anxious patient.

And you think receptionists can make that judgement call?

Must be a postcode lottery thing. I've been seen very quickly when ill, and been given an appointment for the next week when it's just a routine ailment.

So no point in medical school then is there? A routine questionnaire can triage everyone and tell everyone with non obvious symptoms to take Rennies or ibuprofen.

The PP is correct - it takes training and experience to assess when “common symptoms” have crossed a threshold and need further investigation. I know two people in my own circles who died prematurely from “heartburn” which turned out to be angina in need of urgent treatment. Neither were big on the “wine or chips” , neither had predictive factors such as high BP, weight, previous assessments and a receptionist is (a) not qualified to give advice (b) should not be conducting surrogate consultations at reception. Unfortunately one didn’t want to “waste” the GP time and the other couldn’t get an appointment and was told to treat themselves with indigestion remedies (a fact not recorded in the notes).

The whole point of the family doctor system is to have patient histories, ideally some background on the patient and to be able to assess what is minor and treatable at GP level what needs taking further. That is what the years of training and experience attracting the bigger salaries are for. If GPs are unable to provide that service but minimum wage reception staff can fill at check box and that is good enough then what is the point of the system?

I think a study of countries with timely and efficient GP services and further referral (or self referral in some countries), needs to be undertaken, and the best one replicated.

Might cost us more in NI and/or co pay fees, but I think that would be worth it.

Triage staff at surgeries will have guidelines to follow it will not be down to individual opinion or interpretation of symptoms.

Maybe every practice should have someone who just renews prescriptions on a separate line/booking system and he/she can call every prescription patient, check there are no issues with the meds and re-book. They'd save a lot of people calling in taking up GP's time if one person had this as their entire job and any issues the patients get referred to an actual GP to talk to.

@BashfulClam I updated what I meant further down the thread.
I am not expecting receptionists to make/offer medical advice.

The gp fobbed my Dad off. Turned out he had heart failure and dementia. When I stepped in to help the GP was still doing telephone appointments so it transpired he was missing them. I dread to think how much time was wasted.

I might add that this was several years after Covid but they were still doing the bare minimum of appointments face to face.

God help you if you are old or disabled and unable to manage the tech stuff. People will come on and say they should just learn but it’s not as simple as that. My Dad COULD manage tech stuff then he couldn’t. Trying to support him at a distance nearly sent me over the edge. There needs to be a solution that looks at the bigger picture and not just Ted Smith missed his appointment AGAIN.

Tbf they don't do housecalls anymore except for the most housebound, ill patients and even then community nurse teams tend to manage things.

It's a case of go to the practice or go to urgent treatment centres.

That isn’t what you were saying though.

111 also don’t have ‘guidelines’ but algorithms that they have to follow step by step.

My GP refused to come out to see me on 3 separate occasions,when I had a baby and was so ill I couldn’t walk. And looked like some thing from a horror film.

After calling a blue light ambulance because my skin was turning dusky I was diagnosed with Steven Johnson Syndrome. Which can kill you.

There are good and bad GPs. Like in every other walk of life

Reflux is a symptoms of cancer itself and the recommendation is to see your GP if symptoms occur several times a week and over the counter medications are not working.

Breast cancer is a fairly common cancer but at mammography screening women are free of symptoms and 96% don’t need any followup. You are suggesting people with a symptom of another type of cancer, but who also could go one to develop Barrett’s Oesphagus (10-15% with GORD do) don’t see a GP?

I thought that was why they introduced 8am triage to decide who you need to see? So surely it’s their own fault or the fault of the receptionist? When I call for me or my kids (after first trying a pharmacist) I say what the issue is and I’m told who is going to see us.

This is what frustrates me about things like inhalers.

They don't quickly go out of date, and it's something we will always need to use preventatively in our house, so why every 28 days do I have to fill out a form that wastes our time, for a GP to approve it and waste their time, when it could easily be moved to every 2/3 months instead.

I’m very fortunate not to have to go to the GP surgery very often but back before Covid and the advent of online appointments you did tend to see the same old faces in the surgery waiting to see the doctor. Again. One of the receptionists told me most of them didn’t need a GP appointment. Stuff like a kid has woken up with a stiff back. Quick, get him round the doctor’s. Absolute drain on resources.

Lack of common sense. Lack of family support. I want it NOW. I want see the cleverest biggest person, not a scummy little nurse or pharmacist. I've got a sore stomach, notwithstanding I drank 20 pints last night.
I want a letter for benefits, I want a letter for the council, I want a sick line - five minutes ago.

Entitlement.

But you don't need to see a GP if your only symptom is heartburn, it's very easy to check what the symptoms are and contact your GP if you have a majority of symptoms. If that's the case and you have good reason to think it's more than heartburn, then you can go to the GP who can examine you but if they suspect cancer it will need to be referred.

I'm not sure what people think GPs are. They're just people who have been trained to have a good understanding of the human body, deal with more minor complaints and refer bigger ones to specialists. Their own specialism is generalism; by definition, they're not experts in any one particular field.

There's not much a GP can ask you that isn't a routine list of questions that a Receptionist can ask. They can have a feel around and see where you have pain or if anything feels different than a healthy human body, but they don't have X-Ray vision. Some cancers have very vague symptoms and they have to make a judgement call about if there's enough there for a very expensive and stressful referral or if it's likely to just be an over-anxious patient. Sometimes they make the wrong call, but they can only go on the evidence they have.

It's difficult for people to know.

I recently had some symptoms that I wanted a GP appointment for as I thought I would need a prescription. We have a triage system where I am, so I filled in a form, sent photos and a detailed description and asked for a face to face or at least a phone appointment. A couple of hours later, I got a reply that wasn't really anything at all about what I had sent, and saying I couldn't have an appointment or call.

So I went to the pharmacy to see if there actually was anything over the counter I could take. The pharmacist was great and checked my symptoms (as in actually looked at the problem) but agreed I needed a prescription from a GP. Fortunately, she was able to signpost me to a walk in centre in the next town, who then did see me, and was able to prescribe the medication I needed.

It was a lot of hassle when I was feeling unwell, just because my own GP surgery dismissed my concerns as not needing an appointment.

In my case, it wasn't a life threatening condition, but it was painful but easily resolved with the right medication.

Edited to put some breaks in!